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What Do HIV Mouth Sores Look Like?

HIV mouth sores

Mouth sores are a common symptom of human immunodeficiency virus (HIV). In fact, one-third of people with HIV will develop mouth complications due to a weakened immune system.

These mouth sores can interfere with your well-being. In the case of HIV, these sores and infections are more difficult to treat, and can also interfere with eating and medication.

Read on to see what these sores look like and how to treat them.

Find out how HIV affects the body »

What do these mouth sores look like?

Herpes simplex, or cold sores

Fighting off infections and viruses is more difficult when you have HIV. One of the most common viruses that people have is herpes simplex, or oral herpes. Oral herpes usually appears as red sores in your mouth.

When they appear outside the lips, they may look like blisters. Nicknamed “fever blisters,” these red, raised bumps can be painful.

Anyone can get oral herpes, but in someone with HIV or a weakened immune system, oral herpes may be more severe and last longer.

Treatment: Oral herpes is very treatable with medication. Your doctor will likely prescribe acyclovir, an antiviral treatment. This medication helps reduce new outbreaks.

Don’t stop taking your prescription medications until your doctor tells you.

Contagious? Herpes is contagious. Avoid sharing foods when you have herpes.

Aphthous ulcers, or canker sores

Canker sores are common mouth lesions that can cause pain, especially because they don’t go away on their own. Canker sores are usually red, but can also be covered with a gray or yellow film.

They tend to develop inside the cheeks, lips, and around the tongue. These locations may make the sores feel more painful because they move when you speak or eat.

Canker sores aren’t a symptom of HIV, but having HIV can increase your risk for recurring and severe sores. Other factors that can cause canker sores include stress, acidic foods, and mineral deficiencies that include:

  • iron
  • zinc
  • niacin
  • folate
  • glutathione
  • carnitine
  • vitamin B-12

Eating hot or spicy foods while you have a canker sore can also increase pain.

Treatment: In mild cases, over-the-counter (OTC) creams and mouthwashes can reduce inflammation and sores. You can also treat canker sores with salt water.

Your doctor may prescribe corticosteroids in pill form if you have a severe case of canker sores. For cases of prolonged sores that interfere with meals, try topical anesthetic sprays. These can help numb the area.

Contagious? No.

Human papilloma virus (HPV) warts

HPV can cause warts anywhere around the mouth or lips. Warts can look like small cauliflower-like bumps or masses with folds or projections. They can sprout inside and around the mouth.

Most of the time warts are white, but can also be pink or gray. They’re generally not painful, but they can be bothersome. Depending on their location, HIV mouth warts can be picked at and bleed.

HPV is also strongly associated with oropharyngeal cancer, or throat cancer.

Treatment: Your doctor will need to perform surgery to remove warts. You may use a prescription cream for warts on the lips. But there’s no oral medication to treat warts.

Contagious? Possibly, if broken and there’s fluid.

Candidiasis, or thrush

Thrush is a yeast infection that appears as white, yellowish, or red patches anywhere inside the mouth. The patches are sensitive and may bleed or burn when accidentally wiped. In some cases, thrush will cause painful cracks around your mouth (angular cheilitis). Thrush may also spread to the throat, if left untreated.

Treatment: The normal course of treatment for mild thrush is antifungal mouthwash. But HIV can also increase this infection’s resistance. If this is the case, your doctor may prescribe oral antifungal pills.

Contagious? No.

Gum disease and dry mouth

Although these aren’t sores, gum disease (gingivitis) and dry mouth are common problems. Gum disease causes the gums to swell, and can be painful. In severe cases, it can lead to gum or teeth loss in as quick as 18 months. Gum disease may also be an indication of inflammation, which increases your risk for heart disease and stroke.

Dry mouth occurs when you don’t produce enough saliva. Saliva can help protect your teeth as well as prevent infections. Without saliva, your teeth and gums are vulnerable to plaque development. This can also make gum disease worse.

Treatment: Drink water, floss, and brush your teeth consistently to keep your mouth clean and hydrated. For gum disease, your dentist will remove the plaque with a deep cleaning method.

If dry mouth persists, ask your doctor about saliva substitutes.

A timeline of HIV symptoms »

Complications with HIV treatment

Mouth sores can also interfere with HIV treatment. Having a decreased immune function can increase the spread of mouth sores, which tend to multiply in large numbers. This can make swallowing difficult, causing some people to skip medications or meals.

Talk to your doctor if you have a difficult time taking HIV medications due to mouth sores so you can find other treatment options.

Infections

Untreated mouth sores can cause infections. Canker and cold sores can pop when you’re eating or brushing your teeth. Warts and thrush may accidentally be picked off. Open wounds leave you even more vulnerable to infections. Dry mouth also increases the risk for infection because there is not enough saliva to naturally fight bacteria.

Talk to your doctor about treatment for your mouth sores. Prompt treatment reduces the number of mouth sores and the risk for infection.

Preventive oral care

One of the best ways to treat and prevent HIV-related mouth sores is to see your dentist for regular checkups. A dentist can detect problems early on or help prevent sores from worsening. Let your dentist know if you have ongoing mouth sores or infections that won’t go away. They can help with treatment and managing your symptoms.

A guide to living with HIV »

Where to find support

The key to managing HIV is to see your doctor regularly and take your medications. Having mouth sores may make taking your medication more difficult. Talk to your doctor if you have any concerns that interfere with your medication.

You can also contact the CDC National AIDS Hotline at 800-232-4636, if you want to talk to someone about your condition. Someone will pick up your call and be able to offer accurate information about HIV and healthcare obstacles. They can also share their experiences. Or check out other available hotlines at Project Inform. There are hotlines for your state, for women, for people with disabilities, and more.

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